Download Reflections on the Dangers of Hypokinetic Diseases: The Role of

REFLECTIONS ON THE DANGERS OF HYPOKINETIC DISEASES: THE ROLE OF
EXERCISE TOWARDS PREVENTION, MANAGEMENT AND TREATMENT
Atufe Ufuoma
Abstract
This paper looked at reflections on the danger
of hypokinetic diseases and the role of
exercise
towards
their
prevention,
management and treatment. Diseases by their
nature are dangerous and cause slow deaths in
both suspecting and unsuspecting individuals.
Hypokinetic disease is a sedentary illness and
can also be acquired through reckless lifestyles
and genetic endowment. Exercise are physical
activities done for the purpose of getting
physically fit and have been confirmed by
research findings to be a very useful tool in the
prevention, management and treatment of
hypokinetic diseases. This paper examined the
types and consequences of hypokinetic
diseases and also prescribed exercises for
them.
Health varies greatly with income,
gender, age and family origin, and increasing the
span of healthy life is a principal health goal of
Western countries (Blair, 2001). The condition
under which many people, communities or
nations of the world live today is of great
concern to many as it affects their health. Most
people are apprehensive when confronted with
health related issues (Athena, 2000).
Good health is of primary importance to
adults in every society, when polled about
important social values, 99 percent of adults in
the United States identified “being in good
health” as one of their major concerns. The two
other concerns expressed most often were good
family life and good self-image. The 1 percent
who did not identify health as an important
concern had no opinion on any social issues
(Corbin, Welk, Corbin & Welk, 2004).
People sometimes feel immortal because
of the harmful effects of unhealthy lifestyles
which are often not immediate. As we grow
older, we begin to realize that we are not
immortal and that unhealthy lifestyles have
cumulative negative effects which might be
hypokinetic diseases or conditions. Hypo-means
“under” or “too little,” and kinetic means
“movement” or activity. Hypokinetic means “too
little activity”. A hypokinetic disease or
condition is one associated with lack of physical
activity or too little regular exercise. Examples
include heart disease, low back pain, adult-onset
diabetes, obesity and chronic diseases (U.S
Department of Health and Human Services,
2000).
Starting early in life to emphasize
healthy behaviours results in long – term health,
wellness, and fitness benefits. Hypokinetic
diseases are dangerous health conditions that
shortens lives when left unattended to, and
research shows that exercise done on regular
basis assist to prevent the onset of hypokinetic
diseases and also manage and treat them.
According to American College of Sports
Medicine (2002) exercise done on a regular basis
had been recommended according to research
findings, as vital way to sustaining, maintaining
and improving one’s health status for wellness
and longevity purposes (Oboh, Oriabure &
Edafeadhe, 2010). Exercise is physical activity
done for the purpose of getting physically fit
(Armbruster & Godwin, 2001). Exercise is also
seen as activity that is performed for the purpose
of improving, maintaining or expressing a
particular type(s) of physical fitness (Roberg &
Keteyian, 2003).
Journal of Qualitative Education, Volume 8 No. 2, May, 2012, ISSN: 0331 - 4790
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Atufe Ufuoma
Regular exercise in the form of physical
activity and good fitness can promote health,
help prevent disease: One recent study has
shown that physical fitness measured using a
treadmill test is a more powerful predictor of
longevity than any other risk factor, including
smoking, heart problems, high, blood, pressure,
high
cholesterol,
and
diabetes
(www.cdc.gov/nccdphp/sgr/sgr.htm).
In examining the role of exercise
towards the preventing, management and
treatment of hypokinetic diseases, this paper
highlighted the following subheadings: genesis
of hypokinetic diseases, types of hypokinetic
diseases, and hypokinetic diseases, and finally
prescription of exercises for hypokinetic
diseases.
genetic endowment and food and drug related
abuse.
Genesis of Hypokinetic Disease
In 1961, Kraus and Raab coined the term
hypokinetic disease to describe health problem
associated with lack of physical activity. They
showed how sedentary living, or as they called it
“take it easy” living contributes to the leading
killer diseases in our society (Corbin, 2003).
Four of the major causes of death are considered
to be hypokinetic; heart disease, cancer, stroke,
and diabetes. Some experts have differentiated
between hypokinetic diseases such as those listed
and hypokinetic conditions such as back pain
and obesity. Although experts agree that these
are hypokinetic conditions, there is no universal
agreement that conditions such as these are
diseases (American College of Sports Medicine,
2000).
According to Corbin, (2004) studies
show that the symptoms of hypokinetic
conditions begin in youth. This suggests that the
incidence of hypokinetic disease in our culture
will not be reduced without considerable lifestyle
change in people of all ages.
The genesis of hypokinetic diseases
stemmed from three factors; sedentary lifestyle,
2.
1. Sedentary Lifestyle: This means when
an individual is not involved in any
physical activity or participate in
physical exercises. There is the tendency
for fats to sediment through excessive
eating gained from fatty foods. Experts
use the term sedentary death syndrome
(SeDS) to describe a group of symptoms
associated with sedentary living.
Included are weak skeletal muscles, low
bone density, poor metabolic fitness
(high blood sugar and fat levels, obesity,
and high blood pressure at rest), and low
cardiovascular fitness.
Genetic Endowment: Some people with
a family history of disease may conclude
they can do nothing because their
heredity works against them. Certain
families are unfortunately endowed with
hereditary diseases which are passed to
future generations. The onset of these
hypokinetic
diseases
on
future
generations may not manifest early in
life, and certain factors are expected to
trigger them one way or the other
(Ainsworth, 2003).
2. Food and Drug Related Abuse: Food is
meant for human consumption for the
purpose of nourishment and to stay alive.
However, the manner certain foods are
abused
might
have
unpleasant
consequences on the body, its organs and
functions. Some foods have high fatty
cholesterols in them, which might not do
every consumer good after prolonged
consumption. Prolonged consumption of
foods high in fatty cholesterols and sugar
might produce hypokinetic diseases like
heart problem, diabetes. While excessive
Journal of Qualitative Education, Volume 8 No. 2, May, 2012, ISSN: 0331 - 4790
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Reflections on the Dangers of Hypokinetic Diseases: the Role of Exercise Towards Prevention,
Management and Treatment
drug abuse may result in cancer and high
blood pressure, and some toxic drugs
will also cause cancer and other chronic
illnesses and diseases (Athena, 2000).
Types of Hypokinetic Diseases
Hypokinetic
diseases or condition
include heart disease, hypertension, cancer,
stroke, diabetes, low back pain and obesity etc.
1.
Heart Disease: Heart diseases are
classified as cardiovascular diseases. The
many types of cardiovascular diseases
are the leading killers in automated
societies and there are many forms of
cardiovascular disease (CVD). Some are
classified as coronary heart disease
(CHD) because they affect the heart
muscle and the blood vessels inside the
heart. Coronary occlusion (heart attack)
is a type of CHD. Angina pectoris
(chest arm pain), which occurs when the
oxygen supply to the heart muscle is
diminished, is sometimes considered to
be a type of CHD, though it is really a
symptom of poor circulation (Manson,
2002).
Hypertension (high blood pressure),
stroke (brain attack), peripheral vascular
disease, and congestive heart failure are
other forms of CVD. In the United
States, CHD accounts for approximately
31 percent of all premature deaths.
Stroke accounts for an additional 7
percent, and men are likely to suffer
from heart disease than women
(American College of Sports Medicine,
2000).
According to 1998 estimates as reported
by American, Heart Association, Heart
and Stroke Statistical Update in (2001)
60,800,00 Americans have one or more
forms of cardiovascular disease. In 1998
alone, cardiovascular diseases claimed
949,619 lives or 40.6 of all deaths. In
2003, as many as 1,500,000 Americans
will have a new or recurrent heart
attacks, and about one – third of them
will die.
2.
Hypertension or High Blood Pressure
(HBP): Hypertension, or elevated blood
pressure is one of the most prevalent
chronic diseases in the United States.
Simply defined, hypertension is a
chronically elevated blood pressure
greater than 140 / 90 mmHg.
Specifically, a person with hypertension
is defined as having a systolic and / or
diastolic blood pressure reaching greater
than 140 / 90mmHg on two or more
separate occasions, or currently taking
antihypertensive medications (Hagberg,
1991).
Hypertension is related to the
development of CHD, atherosclerosis, stroke,
congestive heart failure, left ventricular
hypertrophy, aortic aneurysms, peripheral arterial
diseases, and kidney failure. The majority of
individuals with high blood pressure are not on
any therapy to control their blood pressure, and
do not even know they have a problem. The
cause of 90% to 95% of the cases of HPB are not
known, but once detected, can be controlled.
Many of the risk factors for
hypertension, such as obesity, excessive alcohol
intake, and physical inactivity, can be controlled.
Hypertension is a serious medical problem if left
untreated, and individuals with it have three to
four times the risk of developing coronary artery
disease, and up to seven times the risk of having
a stroke (Hagberg, 1991).
The detrimental effects of hypertension
are on the heart, brain and kidneys. The heart
must work harder (by generating more pressure)
to pump blood around the body. This increases
the heart’s demand for oxygen and, if
atherosclerosis is present, may cause insufficient
blood flow (ischemia) or induce angina or a
Journal of Qualitative Education, Volume 8 No. 2, May, 2012, ISSN: 0331 - 4790
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Atufe Ufuoma
myocardial infraction (Robergs & Keteyian,
2003). Exceptionally low blood pressures (below
100 systolic and 60 diastolic do not pose the
same risks to health as high blood pressure but,
can cause dizziness, fainting, and lack of
tolerance to change in body positions.
Table 1: Classification of Blood Pressure for Adults
Category
Systolic
Diastolic
Blood Pressure Blood
Pressure
(mmHg)
(mmHg)
Goal
<120
<80
Normal
<130
<85
High normal
130 – 139
85 – 89
Stage 1 hypertension
140 – 159
90 – 99
Stage 2 hypertension
160 – 179
100 - 109
Stage 3 hypertension
 180
110
Source: National Institute of Health in Corbin, (2004)
3.
4.
Cancer: Cancer is referred to any
malignant new growth or tumour in the
body. It can also be seen as a carcinoma
or disorderly growth of epithelial cells
which invade an adjacent tissue and
spread by the lymphatic and blood
vessels to other parts of the body
(Kirkpatrick, 1983). Of the various
cancers (Colon, breast, lung, prostate,
etc), the most studied and the one with
the clearest inverse relationship between
exercise and incidence of disease is
colon cancer (Lee, 1995 & Wells, 1996).
Generally, comparing both occupational
and leisure time activities, sedentary
males and females are at nearly 11/2 – 2 –
fold increased risk for colon cancer
when compared to their active
counterparts.
Stroke (Cerobrovascular Disease):
Stroke is a condition in which the brain,
or part of the brain, receives insufficient
oxygen as a result of diminished blood
supply; sometimes called apoplexy or
cerobrovascular accident (CVA) (Waugh
& Grant, 2001). An increase of damage
to the inner surface of blood vessels may
cause stroke, when the blood supply to
the brain drastically reduces. When the
part of the body that is supposed to be
controlled by the brain did not receive
impulses as a result of insufficient
oxygen to the brain, it will not move or
function as required. Stroke can be
partial or complete stroke. Partial stroke
may be temporal, while complete stroke
involves no movement but comatose
position. The onset of stroke may be
immediate with consistent body signs
(U.S. Department of Health and Human
Services, 1996).
According to Waugh and Grant (2001),
the condition of stroke is a common cause of
death and disability, especially in the elderly. The
predisposing factors include:
 hypertension
 atheroma
 cigarette smoking
 diabetes mellitus
Stroke occurs when a vascular disease
suddenly interrupts flow of blood to the brain
causing hypoxia. The effects include paralysis of
a limb on one side of the body and disturbances
of speech and vision. The nature and extent of
cerebral impairment depends on the size and
location of the affected blood vessels. The main
causes are cerebral infraction (approximate 85%)
and spontaneous intracranial haemorrhage (15%)
(Waugh & Grant, 2001).
5.
Diabetes Mellitus (Diabetes) is a group
of disorders that result when there is too
much sugar in the blood. It occurs when
the body does not make enough insulin
or when the body is not able to use
insulin effectively. Diabetes is the
seventh leading cause of death among
people over forty. It accounts for at least
10 percent of all short-costs in Western
Journal of Qualitative Education, Volume 8 No. 2, May, 2012, ISSN: 0331 - 4790
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Reflections on the Dangers of Hypokinetic Diseases: the Role of Exercise Towards Prevention,
Management and Treatment
society (Corbin et al, 2003). According
to the American Diabetes Association
(ADA), there are 17 million people in
the United States who have diabetes, as
at 2002. Unfortunately, 5.9 million of
those don’t know it.
There are two types of diabetes, type 1
and type 2. Type 1 diabetes, or insulin –
dependent diabetes, accounts for a relatively
small number of the diabetes cases and is not
considered to be a hypokinetic condition. Type II
diabetes (often not insulin – dependent) was
formerly called “adult onset diabetes”. In recent
years, Type II diabetes has become common in
children and is associated with high levels of
body fat (www.healthcanada.ca).
Type II diabetes is the most common
form of diabetes, accounting for about 90% of
cases. Most patients are obese and it tends to
develop in women over 75 years and men over
65 years and the cause is unknown. Insulin
secretion may be below or above normal.
Deficiency of glucose inside body cells may
occur when there is hyperglycaemia and a high
insulin level. This may be due to changes in cell
membrane which block the insulin – assisted
movement of glucose into cells (insulin
resistance) (Waugh & Grant, 2001).
Effects of Diabetes Mellitus
 raised blood glucose level
 weight loss
 ketoacidosis
 diabetes coma
 hyperglycaemic coma
 cardiovascular disturbances
 infection
 renal failure
6. Obesity: This is a very common nutritional
disorder in which there is accumulation of
excess body fat. Clinically, obesity is present
when body weight is 120% of that
recommended for the height, age and sex of
the individual. It occurs when energy intake
exceeds energy expenditure, e.g. in inactive
individuals eating more calories than they
need for energy requirements (Waugh &
Grant, 2001).
 gallstones
 cardiovascular diseases, e.g. ischaemic
heart disease
 hernias
 varicose veins
 osteoarthritis
 type II (non – insulin – dependent)
diabetes
 increased incidence of postoperative
complications.
Consequences of Hypokinetic Diseases
Virtually all chronic diseases that plague
society are considered to be hypokinetic, though
some relate more to inactivity than others. Nearly
three quarters of all deaths among those eighteen
and older are a result of chronic diseases
(Medicine and Science in Sports and Exercise,
2001).
Other consequences of Hypokinetic
Diseases are as follows:
 heart failure
 stroke
 dizziness
 fainting
 kidney infection
 atherosclerosis
 osteroporosis
 insulin sensitivity
 renal failure
 poor blood circulation
 premature death
Exercise and Hypokinetic Diseases
Approximate rate of death from leading
causes shows that heart diseases are at the top.
Exercise plays an important role in preventing
heart disease, as well as in the rehabilitation of
individuals with heart disease (Dawber, Meadors
& Moore, 1991).
Journal of Qualitative Education, Volume 8 No. 2, May, 2012, ISSN: 0331 - 4790
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Atufe Ufuoma
The Role of Exercise in the Prevention,
Management and Treatment of Hypokinetic
Diseases
 Exercise reduces the risk of hypokinetic
diseases by preventing or delaying the
onset of manifestation of the signs and
symptoms in individuals.
 regular exercise improves the physical
fitness of individuals thereby improving
the body immunity to hypokinetic
diseases.
 exercise helps
to increase energy
expenditure, especially for individuals
who expended relatively moderate levels
of energy (>1,000 Kcal /wk).
 research shows that exercise also helps
avoid illnesses such as obesity, stroke,
specific (but not all) cancers, non-insulin
– dependent diabetes, osteoporosis, and
obstructive pulmonary diseases (U.S.
Department of Health and Human
Services, 1996).
 exercise reduces the risk of dying
prematurely
 exercise reduces the risk of developing
high blood pressure
 exercise reduces the depression and
anxiety
 exercise control weight
 exercise build and maintain healthy
bones, muscles, and joints
 exercise helps older adults become
stronger and better able to move without
falling
 exercise promotes psychological wellbeing
 exercise helps in the management and
treatment
of
individuals
whose
movement patterns are disturbed by
stroke or any other hypokinetic diseases
during rehabilitation and therapeutic
stages.
Exercises can be referred to as physical
activities and there are different types prescribed
for various hypokinetic diseases.
Exercise Guidelines and Recommendations
for Heart Diseases and Cancer (Hypertension,
Stroke etc)
 avoid holding breath and straining during
exercise (Valsalva maneurver)
 low weight resistance training should be
used as a supplement to endurance
training, not as the primary exercise.
 some
intensities may need to be
monitored by the RDE (rating of
perceived exertion) scale because some
blood pressure modification can alter the
accuracy of training health rates during
exercise.
 Individuals with hypertension should be
instructed to move slowly when
transitioning from the floor to standing
because they are more susceptible to
orthostatic hypotension, especially if
they are taking an antihypertensive
medication.
 both hypertensive and hypotensive
responses are possible during and after
exercise
for
individuals
with
hypertension.
 individuals with severe hypertension
need to be carefully monitored when
starting an exercise programme, and
possibly long term.
Exercise mode: Endurance activities, such
as walking, running, cycling, swimming, and
so on.
Exercise Intensity: 50% to 60% Vozmax
gradually increasing to 65% to 70% Vozmax.
Journal of Qualitative Education, Volume 8 No. 2, May, 2012, ISSN: 0331 - 4790
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Reflections on the Dangers of Hypokinetic Diseases: the Role of Exercise Towards Prevention,
Management and Treatment
Exercise Frequency: 4 to 5 days / week.
Exercise Duration: 30 min or more (American
College of Sports Medicine, 2000).
Exercise Guidelines for Individuals with
Diabetes
American Diabetes Association (2000)
prescribed the following as guidelines for
individuals with diabetes:
Individuals with diabetes mellitus should
participate in regular physical activity and
preferably perform exercise training as follows:
 do not inject insulin into the muscle
groups to be exercised
 check blood glucose regularly
 always carry a rapid – acting (simple
carbohydrates)
food
to
correct
hypoglycemia
Prescription of Exercises for Individuals with
Hypokinetic Diseases
General Exercise
Recommendations for
Type 1 Diabetes
Component
Recommendation
Type:
Aerobic walking, cycling,
stair- climbing, crosscountry skiing. Strength
training: circuit
programmes using light
weight with 10 – 15
repetitions.
General Exercise
Recommendations for
Type 2 Diabetes
Component
Recommendation
Type:
Aerobic: walking, jogging,
cycling, stair climbing,
cross- country skiing etc.
Strength (moderate level
resistance training): circuit
programme using light
weights with 10 – 15
repetitions.
Intensity:50 – 85% heart
rate reserve or 50 – 85%
Vozmax
Intensity: 50 – 85% heart
rate reserve or 50 – 85%
Vozmax
Duration: 20 – 60 min
plus 5 – 10min warm – up
and cool-down period
Duration: 20 – 60min plus 5
– 10min warm – up and cool
– down period.
Frequency:
Daily to ensure optimal
blood glucose control.
Frequency: 3 – 5 times per
week daily if on insulin
therapy.
Summary and Conclusion
The scourge of hypokinetic diseases to
mankind, especially to adults and the aged is not
to be taken lightly, because more deaths will still
occur as a result of unawareness and negligence.
Individuals from the developing world are highly
susceptible to hypokinetic diseases and hence
more casualty and deaths. According to lots of
research findings, exercise has assisted in the
prevention, management and treatment of
hypokinetic diseases, which this paper had
equally thrown more light on. It is therefore,
expected that if the prescribed exercises are
seriously participated in, casualty and deaths
from hypokinetic diseases will be greatly
reduced.
Recommendations
The following recommendations were
made for the study:
1.
Regular medical check-up should be
done by adults above thirty – five years
of age.
2.
Individuals with parents who died of
hypokinetic diseases should avoid the
same lifestyle their parents lived.
3.
Regular exercise should be done in form
of physical activities on daily basis.
4.
Care should be taken by individuals with
hypokinetic diseases not to over do
prescribed exercises.
5.
The age of individuals with hypokinetic
diseases
should be
taken into
consideration with regards to intensity of
exercises.
6.
Exercises should start from very light to
moderate work-load for the aged.
Journal of Qualitative Education, Volume 8 No. 2, May, 2012, ISSN: 0331 - 4790
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Atufe Ufuoma
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Reflections on the Dangers of Hypokinetic Diseases: the Role of Exercise Towards Prevention,
Management and Treatment
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Atufe Ufuoma
Department of Sports and Health Education
Delta State College of Physical Education,
Mosogar.
Journal of Qualitative Education, Volume 8 No. 2, May, 2012, ISSN: 0331 - 4790
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